C5. Acute limb ischemia in COVID-19 patient: a case report

Abstract

Abstract Background Spread of coronavirus has led to the coronavirus disease (COVID-19) pandemic and resulting in new challenges. COVID-19 can cause thrombotic complications such as acute limb ischemia (ALI). This complication may increase the risk of morbidity and mortality in COVID-19 patient. A high index of suspicion should be maintained for ALI in COVID-19 patient, which is a vascular emergency. Case Description A-53 year old male presented to the emergency department with acute left leg pain and shortness of breath since two days before admission. Physical examination revealed heart rate of 120x/min, blood pressure 130/100 mmHg, and oxygen saturation 96%. The patient had bilateral crackles on lung auscultation and absent left dorsalis pedis pulse. His left foot was discoloured, cold to the touch, and mottled in appearance. He had elevated D-dimer. Chest x-ray showed bilateral hazy infiltrates. COVID-19 was diagnosed on the basis of RT-PCR testing. He received antibiotic, antiviral, and enoxaparin. Unfortunately, he underwent amputation procedure. Discussion COVID-19 has been associated with systemic effects resulting in cardiovascular, hematologic, neurologic, immunologic, and renal complications. Arterial thrombosis is an important consideration in COVID-19 patient associated with systemic inflammatory response, hypercoagulable states, and endothelial injury. ALI can occur during in-hospital evolution of COVID-19 infection or they can be admitted to the hospital for this vascular condition with mild or no respiratory symptoms. Some patients are able to achieve revascularization with observation or medical and/or surgical intervention, but other patients succumb to either amputation or death.